{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T07:41:04Z","timestamp":1776238864002,"version":"3.50.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Townsville Hospital and Health Service Study, Education and Research Trust Account","award":["2021_16"],"award-info":[{"award-number":["2021_16"]}]},{"DOI":"10.13039\/501100001792","name":"James Cook University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001792","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of this study was to quantify the healthcare costs of patients with head and neck cancer (HNC) in Australia and investigate factors associated with increased costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A sub-study was performed using linked patient data from \u2018Lifetime Costs of Surviving Cancer \u2013 A Queensland Study (COS-Q).\u2019 Queensland residents diagnosed with a first primary mucosal head and neck squamous cell carcinoma (HNSCC) between 1997 and 2015 and who incurred costs from 2013 to 2016 were included. Healthcare costs were reported as a total mean cost per patient per year and included emergency department (ED) costs, hospital admission costs, cost for medical and allied health services and pharmaceutical costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 4929 patients with HNSCC included in the study. The total mean annual cost was $21,646 per patient with the highest costs in the first-year post treatment. Regional ($23,312) and rural ($33,627) patients experienced higher healthcare costs than those from major cities ($20,300, p\u2009&lt;\u20090.001). Factors strongly associated with an increased overall healthcare cost included living in a remote location (RR 1.51, p\u2009&lt;\u20090.001), having a nasopharynx (RR 1.41, p\u2009=\u20090.027) or hypopharynx (RR 1.60, p\u2009&lt;\u20090.001) cancer or never married (RR 1.34, p\u2009&lt;\u20090.001). There were 644 patients (13%) who developed a second primary malignancy and this sub-group experienced higher overall costs ($46,453 vs $24,966, p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Healthcare costs for patients with HNC are significant. Further research is needed to investigate ways to reduce healthcare utilisation and provide additional support in this cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-10608-y","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T06:26:41Z","timestamp":1774938401000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare costs in patients with head and neck cancer"],"prefix":"10.1007","volume":"34","author":[{"given":"Justin","family":"Smith","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhavi","family":"Chilkuri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Lindsay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina M. D.","family":"Merollini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"issue":"10318","key":"10608_CR1","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.1016\/S0140-6736(21)01550-6","volume":"398","author":"MD Mody","year":"2021","unstructured":"Mody MD, Rocco JW, Yom SS, Haddad RI, Saba NF (2021) Head and neck cancer. Lancet 398(10318):2289\u20132299. https:\/\/doi.org\/10.1016\/S0140-6736(21)01550-6","journal-title":"Lancet"},{"issue":"9","key":"10608_CR2","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1007\/s40273-014-0169-3","volume":"32","author":"E Wissinger","year":"2014","unstructured":"Wissinger E, Griebsch I, Lungershausen J, Foster T, Pashos CL (2014) The economic burden of head and neck cancer: a systematic literature review. Pharmacoeconomics 32(9):865\u2013882. https:\/\/doi.org\/10.1007\/s40273-014-0169-3","journal-title":"Pharmacoeconomics"},{"issue":"9","key":"10608_CR3","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1158\/1055-9965.EPI-17-0220","volume":"26","author":"DR Lairson","year":"2017","unstructured":"Lairson DR, Wu C-F, Chan W, Dahlstrom KR, Tam S, Sturgis EM (2017) Medical care cost of oropharyngeal cancer among Texas patients. Cancer Epidemiol Biomarkers Prev 26(9):1443\u20131449. https:\/\/doi.org\/10.1158\/1055-9965.EPI-17-0220","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"10608_CR4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.oraloncology.2019.06.033","volume":"96","author":"B Zhao","year":"2019","unstructured":"Zhao B, Fu S, Wu C-F et al (2019) Direct medical cost of oropharyngeal cancer among patients insured by Medicaid in Texas. Oral Oncol 96:21\u201326. https:\/\/doi.org\/10.1016\/j.oraloncology.2019.06.033","journal-title":"Oral Oncol"},{"key":"10608_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/1758-3284-4-15","volume":"4","author":"JJ Jacobson","year":"2012","unstructured":"Jacobson JJ, Epstein JB, Eichmiller FC et al (2012) The cost burden of oral, oral pharyngeal, and salivary gland cancers in three groups: commercial insurance, Medicare, and Medicaid. Head Neck Oncol 4:15. https:\/\/doi.org\/10.1186\/1758-3284-4-15","journal-title":"Head Neck Oncol"},{"issue":"4","key":"10608_CR6","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-019-1256-2","volume":"36","author":"J Polesel","year":"2019","unstructured":"Polesel J, Lupato V, Collarile P et al (2019) Direct health-care cost of head and neck cancers: a population-based study in north-eastern Italy. Med Oncol 36(4):31. https:\/\/doi.org\/10.1007\/s12032-019-1256-2","journal-title":"Med Oncol"},{"issue":"7","key":"10608_CR7","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1111\/jop.12907","volume":"48","author":"K Pollaers","year":"2019","unstructured":"Pollaers K, Massingham I, Friedland PL, Farah CS (2019) The economic burden of oral squamous cell carcinoma in Australia. J Oral Pathol Med 48(7):588\u2013594. https:\/\/doi.org\/10.1111\/jop.12907","journal-title":"J Oral Pathol Med"},{"issue":"8","key":"10608_CR8","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17082831","volume":"17","author":"KMD Merollini","year":"2020","unstructured":"Merollini KMD, Gordon LG, Aitken JF, Kimlin MG (2020) Lifetime costs of surviving cancer\u2014a Queensland study (COS-Q): protocol of a large healthcare data linkage study. Int J Environ Res Public Health 17(8):2831","journal-title":"Int J Environ Res Public Health"},{"issue":"7624","key":"10608_CR9","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","volume":"335","author":"Ev Elm","year":"2007","unstructured":"Elm Ev, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP (2007) Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 335(7624):806\u2013808. https:\/\/doi.org\/10.1136\/bmj.39335.541782.AD","journal-title":"BMJ"},{"issue":"1","key":"10608_CR10","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05253-y","volume":"20","author":"RH Rana","year":"2020","unstructured":"Rana RH, Alam K, Gow J (2020) Selection of private or public hospital care: examining the care-seeking behaviour of patients with private health insurance. BMC Health Serv Res 20(1):380. https:\/\/doi.org\/10.1186\/s12913-020-05253-y","journal-title":"BMC Health Serv Res"},{"key":"10608_CR11","unstructured":"Statistics ABo. Australian Statistical Geography Standard (ASGS) Edition 3. https:\/\/www.abs.gov.au\/statistics\/standards\/australian-statistical-geography-standard-asgs-edition-3\/jul2021-jun2026\/remoteness-structure\/remoteness-areas"},{"issue":"8","key":"10608_CR12","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1111\/imj.13138","volume":"46","author":"J-A Tan","year":"2016","unstructured":"Tan J-A, Otty ZA, Vangaveti VN et al (2016) A prospective comparison of times to presentation and treatment of regional and remote head and neck patients in North Queensland, Australia. Intern Med J 46(8):917\u2013924. https:\/\/doi.org\/10.1111\/imj.13138","journal-title":"Intern Med J"},{"issue":"4","key":"10608_CR13","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1111\/ajr.13005","volume":"31","author":"J Foley","year":"2023","unstructured":"Foley J, Wishart LR, Ward EC et al (2023) Exploring the impact of remoteness on people with head and neck cancer: utilisation of a state-wide dataset. Aust J Rural Health 31(4):726\u2013743. https:\/\/doi.org\/10.1111\/ajr.13005","journal-title":"Aust J Rural Health"},{"issue":"6","key":"10608_CR14","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1002\/hed.27037","volume":"44","author":"J Foley","year":"2022","unstructured":"Foley J, Burns CL, Ward EC et al (2022) Post-acute health care needs of people with head and neck cancer: mapping health care services, experiences, and the impact of rurality. Head Neck 44(6):1377\u20131392. https:\/\/doi.org\/10.1002\/hed.27037","journal-title":"Head Neck"},{"issue":"5","key":"10608_CR15","doi-asserted-by":"publisher","first-page":"4922","DOI":"10.3390\/curroncol30050371","volume":"30","author":"J Smith","year":"2023","unstructured":"Smith J, Yu J, Gordon LG, Chilkuri M (2023) Financial toxicity and out-of-pocket costs for patients with head and neck cancer. Curr Oncol 30(5):4922\u20134935","journal-title":"Curr Oncol"},{"key":"10608_CR16","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.oraloncology.2018.09.025","volume":"86","author":"JC Garneau","year":"2018","unstructured":"Garneau JC, Bakst RL, Miles BA (2018) Hypopharyngeal cancer: a state of the art review. Oral Oncol 86:244\u2013250. https:\/\/doi.org\/10.1016\/j.oraloncology.2018.09.025","journal-title":"Oral Oncol"},{"key":"10608_CR17","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27751","author":"NH Malik","year":"2024","unstructured":"Malik NH, Montero M, Chen JJ, Sinha S, Yom SS, Chan JW (2024) Higher area deprivation index is associated with poorer local control and overall survival in non-metastatic nasopharyngeal carcinoma. Head Neck. https:\/\/doi.org\/10.1002\/hed.27751","journal-title":"Head Neck"},{"key":"10608_CR18","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2579-4","volume":"16","author":"A Auluck","year":"2016","unstructured":"Auluck A, Walker BB, Hislop G, Lear SA, Schuurman N, Rosin M (2016) Socio-economic deprivation: a significant determinant affecting stage of oral cancer diagnosis and survival. BMC Cancer 16:569. https:\/\/doi.org\/10.1186\/s12885-016-2579-4","journal-title":"BMC Cancer"},{"issue":"2","key":"10608_CR19","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1001\/jamaoto.2021.3425","volume":"148","author":"DB Taylor","year":"2022","unstructured":"Taylor DB, Osazuwa-Peters OL, Okafor SI et al (2022) Differential outcomes among survivors of head and neck cancer belonging to racial and ethnic minority groups. JAMA Otolaryngol Head Neck Surg 148(2):119\u2013127. https:\/\/doi.org\/10.1001\/jamaoto.2021.3425","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"10608_CR20","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.oraloncology.2019.06.023","volume":"95","author":"LJ Mady","year":"2019","unstructured":"Mady LJ, Lyu L, Owoc MS et al (2019) Understanding financial toxicity in head and neck cancer survivors. Oral Oncol 95:187\u2013193. https:\/\/doi.org\/10.1016\/j.oraloncology.2019.06.023","journal-title":"Oral Oncol"},{"issue":"3","key":"10608_CR21","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1002\/hed.26016","volume":"42","author":"A Coca-Pelaz","year":"2020","unstructured":"Coca-Pelaz A, Rodrigo JP, Su\u00e1rez C et al (2020) The risk of second primary tumors in head and neck cancer: a systematic review. Head Neck 42(3):456\u2013466. https:\/\/doi.org\/10.1002\/hed.26016","journal-title":"Head Neck"},{"issue":"3","key":"10608_CR22","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1002\/hed.22992","volume":"35","author":"BGM Hughes","year":"2013","unstructured":"Hughes BGM, Jain VK, Brown T et al (2013) Decreased hospital stay and significant cost savings after routine use of prophylactic gastrostomy for high\u2010risk patients with head and neck cancer receiving chemoradiotherapy at a tertiary cancer institution. Head Neck 35(3):436\u2013442. https:\/\/doi.org\/10.1002\/hed.22992","journal-title":"Head Neck"},{"key":"10608_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpo.2023.100463","volume":"39","author":"PR Scholten","year":"2024","unstructured":"Scholten PR, Stalpers LJA, Bronsema I, van Os RM, Westerveld H, van Lonkhuijzen LRCW (2024) The effectiveness of smoking cessation interventions after cancer diagnosis: a systematic review and meta-analysis. J Cancer Policy 39:100463. https:\/\/doi.org\/10.1016\/j.jcpo.2023.100463","journal-title":"J Cancer Policy"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-10608-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-10608-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-10608-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T06:41:23Z","timestamp":1776235283000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-026-10608-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10608"],"URL":"https:\/\/doi.org\/10.1007\/s00520-026-10608-y","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]},"assertion":[{"value":"17 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University of the Sunshine Coast (USC HREC Approval A221792) and the Australian Institute of Health and Welfare (AIHW) Human Research Ethics Committee (EO2017\/3\/348). Approval for data extraction and linkage, including a waiver of consent, was sought from Queensland Health under the Public Health Act 2005 (grant RD007281).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Patient consent was waived due to the use of de-identified, routinely collected administrative data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"389"}}